I'm a 45 year old, HIV+ for 20 years, recently taken off all meds and waiting for the results of a phenotype test. For, my viral load has shut up to 25,000 from 2,000 and my T's have dropped from 700 to 300. Generally, I'm in good health and have never been on a protease inhibitor. Three years ago, I started to lose mass in my face and was diagnosed with lypodistrophy. Last year I started to develop a buffalo hump, which has increased in size though still not too noticeable to anyone but me.
However, over the past few months, I've been suffering with tremendous discomfort in the neck region and with shooting pains down my right arm and tingling/numbness in the fingers of my right hand. A recent MRI showed that the hump may be pressing against my cervical spine, and one of my doctors feels this could be caused by the fat growth. He's suggested surgery to remove the hump, and I've made an appointment with a plastic surgeon recommended by my physician. My other doctor is not crazy about the idea, explaining the probabilities that the hump could grow back and that, in fact, it may not be related to the pain or the tingling. A part of me wants to have it removed anyway. And if the tingling continues, then I know the cause is somewhere else. Can you shed any light on the subject of surgery for this problem? Thank you.

Response from Dr. Moyle

Your doctor is right in saying that the hump may come back after surgery. Additionally, I would say it is unusual (but not impossible) for buffalo humps to cause symptoms of the type you are describing. If the hump is not obvious and you are having a treatment break it may gradually resolve and you could avoid potentially unnecessary surgery. Before deciding anything further you could discuss with your doctor seeing a neurologist to help diagnose the cause of the tingling. If such a specialist thinks it is the fat hump and there is no resolution over the next 3-6 months the you could take discussions with the surgeon further

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